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An HMO may also contract with an existing, independent group practice ("independent group model"), which will generally continue to treat non-HMO patients. Group model HMOs are also considered closed-panel, because doctors must be part of the group practice to participate in the HMO - the HMO panel is closed to other physicians in the community ...
The Health Maintenance Organization Act of 1973 (Pub. L. 93-222 codified as 42 U.S.C. §300e) is a United States statute enacted on December 29, 1973. The Health Maintenance Organization Act, informally known as the federal HMO Act, is a federal law that provides for a trial federal program to promote and encourage the development of health maintenance organizations (HMOs).
Paul Murdock Ellwood Jr. (July 16, 1926 – June 20, 2022) was an American physician and a controversial figure in American health care.Often referred to as the "father of the health maintenance organization", [1] [2] he not only coined the term, he also played a role in bringing about structural changes to the American health care system to simultaneously control cost and promote health by ...
HMO. Health Maintenance Organization plans are often considered the most affordable insurance option. With low deductibles and low copays for doctor visits and pharmaceuticals, HMOs are affordable ...
The HMO backlash Though former President Bill Clinton failed to reform health care in the early 1990s, his administration’s efforts spurred increased concerns over the cost of care.
An HMO Point-of-Service (HMO-POS) plan is a type of HMO plan. With an HMO-POS plan, an individual must choose a PCP, but they can use out-of-network services at a higher cost, similar to a PPO plan.
Unlike PPOs, however, HMOs often require members to select a primary care physician (PCP), a doctor who acts as a gatekeeper to direct access to non-emergency medical services, and are required to first obtain a referral from their PCP in order to be reimbursed for the cost of medical services inside of their network of designated doctors and ...
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